2019
DOI: 10.1111/pace.13806
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Safety and efficacy of transvenous lead extractions for noninfectious superfluous leads in a Japanese population: A single‐center experience

Abstract: Background A challenging decision exists as whether to abandon or remove noninfectious superfluous leads during lead revisions or cardiac implantable electronic device (CIED) upgrades. There is insufficient data in the Asian population to guide decision making. Methods This study investigated the safety and efficacy of transvenous lead extractions (TLEs) in a high‐volume Japanese center. Among a total of 341 patients who underwent lead revisions or CIED upgrades between 2008 and 2018, 53 patients (16%) who und… Show more

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Cited by 12 publications
(18 citation statements)
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“…In Japan, TLE tools and excimer laser sheaths were first approved by the MHLW, Japan in 2008. [7][8][9][10]12 The number of TLEs during the first 3 years was only 98 performed in 9 certified hospitals, and now, more than 600 transvenous lead extractions were performed in more than 50 hospitals in 2019, resulting in more than 4,000 cases over the past decade The registry items for each case in the J-LEX are not complicated but are rather simple since the basic concept of this registry is to gather all the TLE cases in Japan; however, we can collect detailed lead extraction data in all cases during the period the J-LEX will be carried out. We believe that this nationwide Japanese F I G U R E 1 Number of patients and participating institutions.…”
Section: Discussionmentioning
confidence: 99%
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“…In Japan, TLE tools and excimer laser sheaths were first approved by the MHLW, Japan in 2008. [7][8][9][10]12 The number of TLEs during the first 3 years was only 98 performed in 9 certified hospitals, and now, more than 600 transvenous lead extractions were performed in more than 50 hospitals in 2019, resulting in more than 4,000 cases over the past decade The registry items for each case in the J-LEX are not complicated but are rather simple since the basic concept of this registry is to gather all the TLE cases in Japan; however, we can collect detailed lead extraction data in all cases during the period the J-LEX will be carried out. We believe that this nationwide Japanese F I G U R E 1 Number of patients and participating institutions.…”
Section: Discussionmentioning
confidence: 99%
“…[7][8][9][10] Less invasive transvenous LEs (TLEs) may also be performed for abandoned leads in the case of a lead failure or device up-grade, and for lead-related troubles such as pain, vessel stenosis or occlusions, too many leads, tricuspid valve regurgitation, or difficulty with chest radiation therapy. [11][12][13][14] Although TLE complications seem to be acceptable, some major complications such as a cardiac tamponade and hemothorax sometimes occur and lead to a catastrophic outcome. Therefore, a careful assessment of the risk of an LE or whether or not to leave the lead should be required before the procedure.…”
Section: Introductionmentioning
confidence: 99%
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“…All leads were extracted transvenously through a subclavian or femoral approach using the following 4 techniques; (1) manual traction using normal or locking stylets, (2) laser-assisted lead extraction using an excimer laser sheath (3) a mechanical sheath extraction using a non-powered polypropylene dilator sheath (Cook Medical, USA) or a bidirectional rotational mechanical sheath (Evolution RL, Cook Medical, USA), or (4) a snare-assisted lead extraction using various snare tools such as Goose neck snare (Medtronic, Minneapolis, MN, USA), Needle's eye snare (Cook Medical, USA), and Lassos (Osypka, GmbH, Grentzig-Whylen, Germany). 18 Following manual traction, a mechanical sheath extraction and/or laser-assisted lead extraction was selected based on whether there was a venous occlusion or stenosis, lead-lead or lead-tissue adherence, or extensive calcification. Alternatively, among those with severe adhesions in the subclavian, innominate, or superior vena cava veins, a femoral approach using the snaring technique was applied once the tip of the passive fixation lead became free.…”
Section: Tle Proceduresmentioning
confidence: 99%